Paneling Application

Providers may track their application status on-line with a unique tracking number. If additional information or documentation is needed to meet the requirements for your provider type, you may fax the documents to (916) 440-5299.

More Information on provider types is available under the All Other Providers heading on this page.

Dental Providers

Dental providers requesting to treat CCS beneficiaries must be actively enrolled in the Medi-Cal Dental Program (Denti-Cal) and comply with Denti-Cal’s policies, procedures, and requirements. For more information about the Denti-Cal program, ple ase go to the Denti-Cal website.

CCS Medi-Cal Clients

These beneficiaries are eligible for full scope benefits with no share of cost under Medi-Cal. Dental Authorizations and claims are to be sent directly to Denti-Cal and do not require a Service Authorization Request (SAR) from CCS.

CCS-Only and CCS /Healthy Families Clients

These beneficiaries are eligible for screening of Medically Handicapping Malocclusion and may be authorized to receive orthodontic comprehensive State-funded health care and require prior CCS authorization.

All Other Providers

Providers may track their application status on-line with a unique tracking number. If additional information or documentation is needed to meet the requirements for your provider type, you may fax the documents to (916) 440-5299.

The primary provider type is Physicians. All other provider types are identified through the application website referenced above.

Physicians

1.Physicians must be:

a.Licensed as a physician and surgeon by the Medical Board of California or by the Osteopathic Medical Board of California; and

b.Physicians who are not board certified but who are eligible for the certifying examination may participate in the CCS program for not more than three years.A verification letter of eligibility from the applicable member board is required.If the physician does not have a board verification letter, he or she shall submit other evidence regarding eligibility to take the board examination such as a letter from the Medical Director of his or her residency program verifying satisfactory completion of training.

2.Family practice physicians must meet the requirements of number 1 above and have documented experience treating children with CCS eligible medical conditions for at least five years, or have treated 100 or more such children.Please refer to FAQ.

Documented experience means providing the CCS program with a list of cases indicated by a numeric value instead of a name, their CCS-eligible medical condition and the range of dates during which services were rendered.Do not provide the names of the children or any other specific identifiers in your report.

Contact The Systems of Care Division, Provider Services Unit at (916)322-8702 if you have any further questions.